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Infections Caused by Actinomyces neuii: A Case Series and Review of an Unusual Bacterium


Affiliations
1 Provincial Laboratory for Public Health, Walter Mackenzie Health Sciences Centre, University of Alberta Hospital, 8440-112 Street, Edmonton, AB, T6G 2J2, Canada
2 Queen Elizabeth II Hospital, 10409-98 Street, Grande Prairie, AB, T8V 2E8, Canada
3 Red Deer Regional Hospital, 3942-50a Avenue, Red Deer, AB, T4N 4E7, Canada
 

Background: Actinomyces neuii is a Gram-positive bacillus rarely implicated in human infections. However, its occurrence is being increasingly recognized with the use of improved identification systems. Objective: To analyse A. neuii infections in Alberta, Canada, and review the literature regarding this unusual pathogen. Methods: Cases of A. neuii were identified in 2013-2014 in Alberta. Samples were cultured aerobically and anaerobically. A predominant catalase positive Gram-positive coryneform bacillus with no branching was isolated in each case. Testing was initially done with API-CORYNE (bioMerieux) and isolates were sent to the Provincial Laboratory for Public Health for further testing. Isolates’ identities were confirmed by matrix-assisted laser desorption ionization time-of-flight mass spectrometry microbial identification system (MALDI-TOFMS MIS; bioMerieux) and/or DNA sequencing. Results: Six cases of A. neuii infection were identified. All patients had soft tissue infections; typically, incision and drainage were done followed by a course of antibiotics. Agents used included cephalexin, ertapenem, ciprofloxacin, and clindamycin. All had favourable outcomes. Conclusion: While A. neuii is infrequently recognized, it can cause a diverse array of infections. Increased use of MALDI-TOF MS MIS is leading to increased detection; thus, understanding the pathogenicity of this bacterium and its typical susceptibility profile will aid clinical decision-making.
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  • Infections Caused by Actinomyces neuii: A Case Series and Review of an Unusual Bacterium

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Authors

Nathan Zelyas
Provincial Laboratory for Public Health, Walter Mackenzie Health Sciences Centre, University of Alberta Hospital, 8440-112 Street, Edmonton, AB, T6G 2J2, Canada
Susan Gee
Provincial Laboratory for Public Health, Walter Mackenzie Health Sciences Centre, University of Alberta Hospital, 8440-112 Street, Edmonton, AB, T6G 2J2, Canada
Barb Nilsson
Queen Elizabeth II Hospital, 10409-98 Street, Grande Prairie, AB, T8V 2E8, Canada
Tracy Bennett
Red Deer Regional Hospital, 3942-50a Avenue, Red Deer, AB, T4N 4E7, Canada
Robert Rennie
Provincial Laboratory for Public Health, Walter Mackenzie Health Sciences Centre, University of Alberta Hospital, 8440-112 Street, Edmonton, AB, T6G 2J2, Canada

Abstract


Background: Actinomyces neuii is a Gram-positive bacillus rarely implicated in human infections. However, its occurrence is being increasingly recognized with the use of improved identification systems. Objective: To analyse A. neuii infections in Alberta, Canada, and review the literature regarding this unusual pathogen. Methods: Cases of A. neuii were identified in 2013-2014 in Alberta. Samples were cultured aerobically and anaerobically. A predominant catalase positive Gram-positive coryneform bacillus with no branching was isolated in each case. Testing was initially done with API-CORYNE (bioMerieux) and isolates were sent to the Provincial Laboratory for Public Health for further testing. Isolates’ identities were confirmed by matrix-assisted laser desorption ionization time-of-flight mass spectrometry microbial identification system (MALDI-TOFMS MIS; bioMerieux) and/or DNA sequencing. Results: Six cases of A. neuii infection were identified. All patients had soft tissue infections; typically, incision and drainage were done followed by a course of antibiotics. Agents used included cephalexin, ertapenem, ciprofloxacin, and clindamycin. All had favourable outcomes. Conclusion: While A. neuii is infrequently recognized, it can cause a diverse array of infections. Increased use of MALDI-TOF MS MIS is leading to increased detection; thus, understanding the pathogenicity of this bacterium and its typical susceptibility profile will aid clinical decision-making.